Rh omicron blood testing serum

ABSTRACT

RH0 TESTING SERUM COMPRISES ANTI-RH0 INCOMPLETE ANTIBODY OF HUMAN ORIGIN AND ANTI-RH0 COMPLETE ANTIBODY OF ANIMAL ORIGIN, THE COOMBS TITRE AND THE AGGLUTININ TITRES BEING AT LEAST ABOUT 32 AND ABOUT 16, RESPECTIVELY, THE RATIO OF COOMBS TITRE TO AGGLUTININ TITRE BEING FROM ABOUT 1:2 TO ABOUT 8:1.

United States Patent fice 3,579,627 RH BLOOD TESTING SERUM Zenro Hayakawa, Matsumoto, Japan, assignor to Takeda Chemical Industries, Ltd., Osaka, Japan No Drawing. Filed Sept. 29, 1967, Ser. No. 671,550

Claims priority, application Japan, Sept. 29, 1966, 41/ 64,581

Int. Cl. G01n 33/16 US. Cl. 424-11 2 Claims ABSTRACT OF THE DISCLOSURE Rh testing serum comprises anti-Rh incomplete antibody of human origin and anti-Rh complete antibody of animal origin, the Coombs titre and the agglutinin titres being at least about 32 and about 16, respectively, the ratio of Coombs titre to agglutinin titre being from about 1:2 to about 8:1.

This invention relates to Rh blood testing serum. More particularly, this invention relates to Rh blood testing serum which contains anti-Rh incomplete antibody sometimes also referred to as blocking antibodyof human origin and anti-Rh complete antibody of animal origin.

Since Landsteiner and Wiener discovered a new blood factor in the blood of human beings and designated it as Rh factor, extensive studies have been carried out to find new blood factors in relation to the Rh factor. As a result, the present Rh blood type system of human beings has been established. There are two typical series of nomenclature of the factors in this Rh blood type system; one is the Wiener nomenclature and the other is the Fisher-Race nomenclature. The relationship between the two series of nomenclature is briefly shown as follows for the practical use of these factors:

Wiener nomenclature- Fisher-Race nomenclature rh' C r E Rh-:

Hr (1 hr c hr!) w e (1) Before every transfusion or injection of blood to patients, irrespective of age and sex;

(2) In every pregnancy;

(3) When an infant is born, especially if its mother has such a medical history that one or more of her pregnancies have resulted in some hemolytic diseases of her fetuses or babies, or it is known that her blood contains Rh antibodies, or when there is any clinical ground to suspect that the infant has a hemolytic disease;

(4) When a female in whom Rh antibody has already been formed desires a prediction as to whether or not there is any chance that an Rh positive infant may be born; or

3,579,627 Patented May 18, 1971 (5) When Rh negative blood donors are to be selected.

At present, the following three types of sera are employed as Rh testing sera:

(a) Rh testing serum comprising anti-Rh complete antibody of human origin;

(b) Rh testing serum comprising anti-Rh incomplete antibody of human origin; and

(c) Rh testing serum comprising antiRh complete antibody of animal origin.

However, the Rh testing serum comprising anti-Rh complete antibody of human origin is bound up with the drawback that its production on a commercial scale is very difficult. More concretely, though the antiserum comprising the anti-Rh complete antibody of human origin is generally obtained from the blood of volunteers belonging to the Rh -negative group who are immunized with the antigen-positive human blood cells, the anti-Rh complete antibody is produced only just after the immunization. Therefore, the production of the antiserum comprising such anti-Rh complete antibody is very difficult.

Furthermore, though it is possible with the use of said antiserum comprising the anti-Rh complete antibody of human origin to determine whether or not Rh antigen per se is present in the red cells of a subject, it is impossible with the use of the same to determine whether or not such antigen as (D antigen (which is a variant type of Rh antigen) or Rh III antigen (which is a partial antigen of Rh antigen) is present in the red cells.

On the other hand, as the Rh testing procedure which involves employment of Rh testing serum comprising anti-Rh incomplete antibody of human origin, the Coombs test in which the said antiserum and Coombs serum are employed is most preferably employed, since the Coombs test is necessary for clearly determining whether or not 0 antigen as Well as Rh antigen is present in the red cells of a subject, but also can be carried out with use of a red cell suspension in a physiological saline.

However, the said Coombs test is accompanied by such drawbacks that it involves not only the employment of a large amount of Coombs serum but rather troublesome techniques. Therefore, it is almost impossible to apply this test to all subjects to be tested.

Under these circumstances, the following test procedure has been proposed and is widely employed in such contries as Japan, as the most practical and economical Rh testing system:

(a) A red cell suspension in a physiological saline is firstly tested with the use of an Rh testing serum comprising anti-Rh complete antibody of animal origin. A subject whose red cells are positive to the said test is determined as normal Rh -lhaving Rh III antigen.

(b) Red cell suspensions which show negative or vague reaction to the above-mentioned test are subsequently subjected to the Coombs test employing both Rh test ing serum comprising anti-Rh incomplete antibody of human origin and the Coombs serum. A subject whose red cells are positive to this Coombs test is determined as Rh which lacks Rh III antigen or and a Slabject whose red cells are negative is determined as a ho However, in the said Rh testing procedure the trouble is that it is indispensable to employ two kinds of Rh testing serum, i.e. Rh testing serum comprising anti-Rh complete antibody of animal origin in the first step and Rh testing serum comprising anti-Rh incomplete antibody of human origin in the second step. When it is taken into consideration that such Rh testing procedure is carried out in rather small medical practitioners offices, the

Biological Preparations pp. 193 to 195. The maximum dilution of the diluted Rh testing serum, red cell suspension treated thereby showing agglutination with the Coombs serum is termed the Coombs titre.

6 serum which comprises anti-Rh complete antibody (agglutinin titre 32). The result of the agglutination reaction between Rh positive red cells and the resultant mixtures is summarized in Table 1:

TABLE 1 Times Dilution of the human serum 2 3 6 12 24 48 96 192 384 Type of Rho posl tive red cells nim. 13411111.. o-m

See notes following Table 3.

From the viewpoint of practical use of the Rh testing serum in the Rh testing procedure, it is especially advantageous to admix anti-Rh incomplete antibody of human origin with anti-Rh complete antibody of animal origin so that the Coombs titre of the resultant Rh testing serum is in the range from about 32 to about 128 and the agglutinin titre of the same in the range from about 16 to about 64.

However, as the Rh testing serum of the present invention can be employed in the Rh testing procedure after being diluted with a suitable diluent such as a physiological saline as far as the resultant diluted serum has the Coombs titre not less than about 32 and the agglutinin titre not less than about 16, the anti-Rh incomplete antibody of human origin may be admixed with the anti-Rh complete antibody of animal origin so as to make the Coombs titre more than about 128 and the agglutinin titre more than about 64. In this case, from the practical point of view in the use of the Rh testing serum in the testing procedure, it is most advantageous to admix the anti-Rh incomplete antibody of human origin with the anti-Rh complete antibody of animal origin, in a such ratio that the Coombs titre of the resultant Rh testing serum is about 1:2 to about 8:1 relative to the agglutinin titre of the same.

Thus-prepared Rh testing serum of the present invention can be used in both the first step and the second step (the Coombs test) in the said Rh testing procedure. For example,

Dilution of the serum mixtures with a physiological solutlon Not diluted 2 3 8 The human serum=gnlnea pig serum by volume ratio:

(1) The first step: Red cell suspensions in a physiological saline are tested with the use of only the Rh testing serum of the present invention, whereby the anti- Rh complete antibody contained in the serum agglutinates the normal Rh +red cells, but does not agglutinate Rh +red cells which lack Rh III antigen.

(2) The second step: Red cell suspensions which show negative or vague reaction to the first test are directly subjected to the Coombs test with the use of the Coombs serum and without using further anti-Rh incomplete antibody of human origin, whereby the anti-Rh incomplete antibody in the present Rh testing serum contained in the suspension agglutinates Rh +red cells which lack Rh III antigen, 0 red cells, or Rh -i-red cells of weak antigen.

RUNl

Human serum comprising anti-Rh incomplete antibody (Coombs titre 1280) is diluted 2, 3, 6, 12, 24, 48, 96, 192, and 384 times with a physiological saline. To each diluted solution is added the equal volume of guinea-pig As clearly shown in Table 1, the anti-Rh incomplete antibody of human origin never blocks the agglutination of Rh positive red cells with the anti-Rh complete antL body of the animal origin.

RUN2

(a) A human serum comprising anti-Rh incomplete antibody is diluted 10 times with a 30% aqueous human albumin solution. The Coombs titre of the ten-fold diluted serum is measured to give the result shown in Table 2, from which the titre is determined as 128.

(b) The same human serum comprising anti-Rh incomplete antibody as employed in (a) is diluted 10, 20, 40 or times with guinea-pig serum which comprises anti-Rh complete antibody of the agglutinin titre 16.

The Coombs titre of each resultant mixture is measured to give the result shown in Table 3.

TABLE 3 Times NOTES TO TABLES 1, 2 AND 3 Completely negative +Very slightly agglutinated +Slight agglutinated +Moderately agglutinated +Strongly agglutinated (All are macroscopical observations.)

Comparison of Table 3 with Table 2 shows clearly that the human serum comprising anti-Rh incomplete antibody exhibits the same Coombs titre when diluted 10 times with the 30% aqueous human albumin solution and when diluted 40 times with the guinea-pig serum comprising anti-Rh complete antibody. This means that the Coombs titre of human incomplete antibody is enhanced about four times by the guinea-pig serum comprising anti-Rh complete antibody.

EXAMPLE 1 39 parts by volume of an Rh testing serum comprising anti-Rh complete antibody of guinea-pig origin, which is UNITED STATES PATENT oFFicE CERTIFiCATE 0F CORRECTION Patent Inventgr(s) ZENRO HAYAKAWA It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

In Claim 1, the phrase "incomplete antibody of human origin and anti-Rh has been omitted between lines 1 and 2 of the claim.

Signed and sealed this 22nd day of February 1972.

(SEAL) Attest:

EDWARD M.FLETGHLEH%,JR. ROBERT GOTTSCHALK Attesting Officer Commissioner of Patents F ORM PO-EUSO (ID-69) uscoMM-DC 0375 25 u 5 GOVERNMENT PRINTING OFFICE 1969 0-3664 

